EANM procedure guideline for radio-immunotherapy for B-cell lymphoma with 90Y-radiolabelled ibritumomab tiuxetan (Zevalin)
In January 2004, EMEA approved 90Y-radiolabelled ibritumomab tiuxetan, Zevalin, in Europe for the treatment of adult patients with rituximab-relapsed or -refractory CD20+ follicular B-cell non-Hodgkin’s lymphoma. The number of European nuclear medicine departments using Zevalin is continuously increasing, since the therapy is often considered successful. The Therapy, Oncology and Dosimetry Committees have worked together in order to define some EANM guidelines on the use of Zevalin, paying particular attention to the problems related to nuclear medicine.
The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients who may be candidates for radio-immunotherapy. The guideline also stresses the need for close collaboration with the physician(s) treating the patient for the underlying disease.
KeywordsGuidelines Nuclear medicine 90Y-ibritumomab tiuxetan Non-Hodgkin’s lymphoma Radioimmunotherapy
The European Association of Nuclear Medicine has written and approved guidelines to promote the cost-effective use of high-quality nuclear medicine procedures. These generic recommendations cannot be rigidly applied to all patients in all practice settings. The guidelines should not be deemed inclusive of all proper procedures or exclusive of other procedures reasonably directed to obtaining the same results. Advances in medicine occur at a rapid rate. The date of particular guidelines should always be considered in determining their current applicability.
- 7.Press OW, Leonard JP, Coiffier B, Levy R, Timmerman J. Immunotherapy of Non-Hodgkin’s lymphoma. Hematology 2001;221–40.Google Scholar
- 11.Wiseman GA, Kornmehl E, Leigh B, Erwin WD, Podoloff DA, Spies S, et al. Radiation dosimetry results and safety correlations from 90Y-ibritumomab tiuxetan radioimmunotherapy for relapsed or refractory non-Hodgkin’s lymphoma: combined data from 4 clinical trials. J Nucl Med 2003;44(3):465–7.PubMedGoogle Scholar
- 12.Wiseman GA, White CA, Sparks RB, Erwin WD, Podoloff DA, Lamonica D, et al. Biodistribution and dosimetry results from a phase III prospectively randomized controlled trial of Zevalin radioimmunotherapy for low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. Crit Rev Oncol Hematol 2001;39(1–2):181–94.PubMedGoogle Scholar
- 14.Witzig TE, Gordon LI, Cabanillas F, Czuczman MS, Emmanouilides C, Joyce R, et al. Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin’s lymphoma. J Clin Oncol 2002;20:2453–63.PubMedCrossRefGoogle Scholar
- 19.European Medicines Agency. http://www.emea.eu.int/humandocs/PDFs/EPA.R/zevalin